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<ClinicalDocument xmlns="urn:hl7-org:v3" xmlns:sdtc="urn:hl7-org:sdtc" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="urn:hl7-org:v3 CDA.xsd">
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<realmCode code="IT"/>
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<typeId extension="POCD_MT000040UV02" root="2.16.840.1.113883.1.3"/>
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<templateId assigningAuthorityName="HL7 Italia" extension="1.1" root="2.16.840.1.113883.2.9.10.1.9.1"/>
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<id assigningAuthorityName="Regione Lombardia" extension="GEPAWEB_527953_1" root="2.16.840.1.113883.2.9.2.120.4.4"/>
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<code code="11488-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName=" Nota di consulto">
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</code>
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<title> Referto di Specialistica Ambulatoriale </title>
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<effectiveTime value="20251110095618+0100"/>
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<confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25" codeSystemName="HL7 Confidentiality" displayName="Normal"/>
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<languageCode code="it-IT"/>
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<setId assigningAuthorityName="Regione Lombardia" extension="GEPAWEB_527953_1" root="2.16.840.1.113883.2.9.2.120.4.4"/>
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<versionNumber value="1"/>
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<recordTarget>
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<patientRole classCode="PAT">
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<id assigningAuthorityName="Ministero Economia e Finanze" extension="VNTPSQ97E66A971K" root="2.16.840.1.113883.2.9.4.3.2"/>
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<addr use="H">
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<city>Modena</city>
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<country>ITA</country>
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<streetAddressLine>Via Dei Chiodi, 5</streetAddressLine>
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</addr>
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<telecom nullFlavor="NI" use="H"/>
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<telecom nullFlavor="NI" use="HP"/>
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<patient>
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<name>
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<prefix>Signora</prefix>
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<family>VENTIQUATTRO</family>
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<given>PASQUA</given>
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<delimiter/>
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</name>
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<administrativeGenderCode code="F" codeSystem="2.16.840.1.113883.5.1" codeSystemName="HL7 AdministrativeGender" displayName="Femmina"/>
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<birthTime value="19970526"/>
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<birthplace>
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<place>
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<addr>
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<city>Bonefro</city>
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<country>ITA</country>
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</addr>
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</place>
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</birthplace>
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</patient>
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</patientRole>
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</recordTarget>
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<author>
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<time value="20251110095618+0100"/>
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<assignedAuthor classCode="ASSIGNED">
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<id assigningAuthorityName="MEF" extension="PROXY_SIGN_ASLAT" root="2.16.840.1.113883.2.9.4.3.2"/>
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<telecom nullFlavor="NI" use="HP"/>
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<telecom use="MC" value="tel:0835/336836"/>
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<assignedPerson>
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<name>
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<prefix>Dott.</prefix>
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<given>User</given>
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<family>System</family>
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</name>
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</assignedPerson>
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</assignedAuthor>
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</author>
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<custodian>
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<assignedCustodian>
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<representedCustodianOrganization>
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<id assigningAuthorityName="Ministero della Salute" extension="010206" root="2.16.840.1.113883.2.9.2.10206"/>
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<name>Azienda Socio Sanitaria Territoriale di Lodi</name>
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<telecom use="HP" value="0371371"/>
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<addr>
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<country>100</country>
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<city>Lodi</city>
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<state>Italia</state>
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<streetAddressLine>Piazza Ospitale 10</streetAddressLine>
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<postalCode>26900</postalCode>
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</addr>
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</representedCustodianOrganization>
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</assignedCustodian>
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</custodian>
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<legalAuthenticator>
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<time value="20251110095618+0100"/>
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<signatureCode code="S"/>
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<assignedEntity>
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<id assigningAuthorityName="MEF" extension="PROXY_SIGN_ASLAT" root="2.16.840.1.113883.2.9.4.3.2"/>
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<telecom nullFlavor="NI" use="HP"/>
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<telecom use="MC" value="tel:0835/336836"/>
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<assignedPerson>
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<name>
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<prefix>Dott.</prefix>
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<given>User</given>
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<family>System</family>
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</name>
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</assignedPerson>
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</assignedEntity>
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</legalAuthenticator>
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<inFulfillmentOf>
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<order classCode="ACT" moodCode="RQO">
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<id assigningAuthorityName="MEF" extension="1234567" root="2.16.840.1.113883.2.9.4.3.9"/>
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<priorityCode code="R" codeSystem="2.16.840.1.113883.5.7" codeSystemName="HL7 ActPriority" displayName="Classe A"/>
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</order>
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</inFulfillmentOf>
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<documentationOf>
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<serviceEvent>
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<code code="PROG" codeSystem="2.16.840.1.113883.2.9.5.1.4" codeSystemName="ActCode" displayName="Accesso Programmato"/>
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<effectiveTime value="20251110095618+0100"/>
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</serviceEvent>
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</documentationOf>
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<componentOf>
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<encompassingEncounter>
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<id assigningAuthorityName="MEF" extension="GEPA527953" root="2.16.840.1.113883.2.9.2.120110.4.6"/>
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<effectiveTime>
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<low value="20251110095618+0100"/>
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<high value="20251110095618+0100"/>
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</effectiveTime>
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<location>
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<healthCareFacility>
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<id assigningAuthorityName="Ministero della Salute" extension="120103.XX.49" root="2.16.840.1.113883.2.9.4.1.6"/>
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<location>
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<name>Prima visita</name>
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</location>
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</healthCareFacility>
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</location>
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</encompassingEncounter>
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</componentOf>
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<component>
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<structuredBody classCode="DOCBODY" moodCode="EVN">
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<component typeCode="COMP">
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<section ID="PRESTAZIONI">
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<code code="62387-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Interventi"/>
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<title> Prestazioni </title>
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<text>
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<paragraph>
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<caption>Prestazioni Eseguite</caption>
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</paragraph>
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<list>
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<item ID="Prestazione-1">
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<table>
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<thead>
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<tr>
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<th>Prestazione 1</th>
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</tr>
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</thead>
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<tbody>
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<tr>
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<th>Codice Prestazione</th>
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<td>89.7</td>
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</tr>
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<tr>
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<th>Descrizione Prestazione eseguita</th>
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<td>VISITA GENERALE visita specialistica, prima visita. - 89.7</td>
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</tr>
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<tr>
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<th>Data Prestazione eseguita</th>
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<td>20251110095618+0100</td>
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</tr>
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</tbody>
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</table>
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<paragraph>
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<caption> Procedure Operative Eseguite</caption>
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</paragraph>
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<list>
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<item ID="Procedure-1">
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<table border="1">
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<thead>
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<tr>
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<th colspan="2">Procedura 1</th>
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</tr>
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</thead>
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<tbody>
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<tr>
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<th>Codice Prestazione Eseguita</th>
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<td>89.7</td>
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</tr>
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<tr>
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<th>Descrizione Procedura Operativa</th>
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<td>VISITA GENERALE visita specialistica, prima visita. - 89.7</td>
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</tr>
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</tbody>
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</table>
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</item>
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</list>
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</item>
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</list>
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</text>
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<entry>
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<act classCode="ACT" moodCode="EVN">
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<code code="89.7" codeSystem="2.16.840.1.113883.2.9.6.1.11" codeSystemName="MEF" displayName="VISITA GENERALE visita specialistica, prima visita. - 89.7">
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<originalText>
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<reference value="Prestazione-1"/>
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</originalText>
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</code>
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<effectiveTime value="20251110095618+0100"/>
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<entryRelationship typeCode="COMP">
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<procedure classCode="PROC" moodCode="EVN">
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<code code="89.7" codeSystem="2.16.840.1.113883.2.9.6.1.11" codeSystemName="MEF" displayName="VISITA GENERALE visita specialistica, prima visita. - 89.7">
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<originalText>
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<reference value="#Procedure-1"/>
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</originalText>
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</code>
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<effectiveTime value="20251110095618+0100"/>
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</procedure>
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</entryRelationship>
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</act>
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</entry>
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</section>
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</component>
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<component typeCode="COMP">
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<section ID="REFERTO">
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<code code="47045-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Referto"/>
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<title>Referto</title>
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<text>
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<paragraph>
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Relazione di prova
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</paragraph>
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</text>
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</section>
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</component>
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</structuredBody>
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</component>
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</ClinicalDocument>
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